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        <title>COWS | Registration</title>
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                <!-- logo -->
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                    <ul>
                        <li>
                            <a href="" title="Register" class="active">Register</a>
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                        <li>
                            <a href="./login.html" title="Log In">Log In</a>
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                    <div class="login_content">
                        <div class="icon_id left">
                        </div>
                        <div class="left">
                            <h4 class="subhead left span-10">CREATE A COWS ACCOUNT</h4>
                        </div>
                        <div class="right" style="width: 190px">
                            <div class="spacer">
                            </div>
                        </div>
                    </div>
                </div>
                <div class="clear">
                </div>
                <div class="login_content">
                    <!-- begin form -->
                    <div class="spacer">
                    </div>
                    <form id="login_frm" name="login_frm" action="./checkregister.php" method="post">
                        <div class="left">
                            <img src="./images/login/icon_personal.gif" style="margin-top: 3px"/>&nbsp;&nbsp;&nbsp;
                        </div>
                        <div class="header_form left" style="width: 300px">
                            Personal Profile
                        </div>
                      <div class="clear spacer">
                        </div>
                        <table name="tblCreateAcct" id="tblCreateAcct" cellspacing="0" cellpadding="10" border="0" width="100%" class="gray_table left">
                            <tr>
                                <td align="right" width="150" height="60" valign="middle">
                                    <label>
                                        First Name:
                                    </label>
                                </td>
                                <td width="400" valign="middle">
                                    <input class="text_box" type="text" name="txtFirstName" id="txtFirstName" value="" />
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Last Name:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="txtLastName" id="txtLastName" value="" />
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Email Address :
                                    </label>
                                </td>
                              <td valign="middle">
                                    <input class="text_box" type="text" name="txtEmail" id="txtEmail" value="" />
                                    <span class="input_caption">This will be your log in ID</span>
<div class="clear">
</div></td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Password:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input type="password" class="text_box" name="Password" id="Password" value="" />
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Confirm Password:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input name="txtPassword2" type="password" class="text_box" id="txtPassword2" value="" />
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                        </table>
                        <div class="clear">
                        </div>
                        <div class="spacer">
                        </div>
                        <div class="left">
                            <img src="./images/login/icon_business.gif" style="margin-top: 3px"/>&nbsp;&nbsp;&nbsp;
                        </div>
                        <div class="header_form left" style="width: 300px">
                            Shipping Information
                        </div>
                        <div class="clear spacer">
                        </div>
                        <table name="tblCreateAcct" id="tblCreateAcct" cellspacing="0" cellpadding="10" border="0" width="100%" class="gray_table left">
                            <tr>
                                <td align="right" width="150" height="60" valign="middle">
                                    <label>
                                        Country:
                                    </label>
                                </td>
                                <td width="400" valign="middle">
                                    <select name="country" class="text_box" id="country" style="">
                                        <option value="CND" selected="selected">Canada</option>
                                    </select>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Province:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <select name="province" id="province" style="">
                                        <option value="" selected="selected">Select one...</option>
                                        <option value="BC">BC</option>
                                        <option value="AB">AB</option>
                                        <option value="MB">MB</option>
                                        <option value="NB">NB</option>
                                        <option value="NL">NL</option>
                                        <option value="NT">NT</option>
                                        <option value="NS">NS</option>
                                        <option value="NU">NU</option>
                                        <option value="ON">ON</option>
                                        <option value="PE">PE</option>
                                        <option value="QC">QC</option>
                                        <option value="SK">SK</option>
                                        <option value="YT">YT</option>
                                    </select>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        City:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="city" id="city" value="" />
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Street Address:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="streetAddress" id="streetAddress" value="" />
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Postal Code:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="postalCode" id="postalCode" value="" />
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Phone Number:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="phone" id="phone" value="" />
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                        </table>
						<div class="clear">
                        </div>
                        <div class="spacer">
                        </div>
                        <div class="left">
                            <img src="./images/login/icon_business.gif" style="margin-top: 3px"/>&nbsp;&nbsp;&nbsp;
                        </div>
                        <div class="header_form left" style="width: 300px">
                            Billing Information
                        </div>
                      <div class="clear spacer">
                        </div>
                        <table name="tblCreateAcct" id="tblCreateAcct" cellspacing="0" cellpadding="10" border="0" width="100%" class="gray_table left">
                          <tr>
                            <td height="60" align="right" valign="middle"><label> </label>
                              <label for="sameship">Same as Shipping:</label></td>
                            <td valign="middle"><input type="checkbox" name="sameship" id="sameship" /></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td height="60" align="right" valign="middle"><label> Country: </label></td>
                            <td valign="middle"><select name="country2" id="country2" style="">
                              <option value="CND" selected="selected">Canada</option>
                            </select></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td align="right" valign="middle"><label> Province: </label></td>
                            <td valign="middle"><select name="province2" id="province2" style="">
                              <option value="" selected="selected">Select one...</option>
                              <option value="BC">BC</option>
                              <option value="AB">AB</option>
                              <option value="MB">MB</option>
                              <option value="NB">NB</option>
                              <option value="NL">NL</option>
                              <option value="NT">NT</option>
                              <option value="NS">NS</option>
                              <option value="NU">NU</option>
                              <option value="ON">ON</option>
                              <option value="PE">PE</option>
                              <option value="QC">QC</option>
                              <option value="SK">SK</option>
                              <option value="YT">YT</option>
                            </select></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td align="right" valign="middle"><label> City: </label></td>
                            <td valign="middle"><input class="text_box" type="text" name="city2" id="city2" value="" />
                              <div class="clear"></div></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td align="right" valign="middle"><label> Street Address: </label></td>
                            <td valign="middle"><input class="text_box" type="text" name="streetAddress2" id="streetAddress2" value="" />
                              <div class="clear"></div></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td align="right" valign="middle"><label> Postal Code: </label></td>
                            <td valign="middle"><input class="text_box" type="text" name="postalCode2" id="postalCode2" value="" />
                              <div class="clear"></div></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                          <tr>
                            <td align="right" valign="middle"><label> Phone Number: </label></td>
                            <td valign="middle"><input class="text_box" type="text" name="phone2" id="phone2" value="" />
                              <div class="clear"></div></td>
                            <td align="left" valign="middle"><div class="td_spacer"></div></td>
                          </tr>
                            <tr>
                                <td align="right" width="150" height="60" valign="middle">
                                    <label>
                                        Payment Method:
                                    </label>
                                </td>
                                <td width="220" valign="middle">
                                    <select name="credit" id="credit" style="">
                                        <option value="CC" selected="selected">Credit Card</option>
										<option value="PP">Pay Pal</option>
                                    </select>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Card Number:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <input class="text_box" type="text" name="cardnum" id="cardnum" value="" />
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td align="right" valign="middle">
                                    <label>
                                        Expiry Date:
                                    </label>
                                </td>
                                <td valign="middle">
                                    <select name="cardyear" class="ccselect" id="cardyear" style="">
                                        <option value="year" selected="selected">Year</option>
										<option value="11">11</option>
										<option value="12">12</option>
										<option value="13">13</option>
										<option value="14">14</option>
										<option value="15">15</option>
										<option value="16">16</option>
                                    </select>
									<select name="cardmonth" class="ccselect" id="cardmonth" style="">
                                        <option value="month" selected="selected">Month</option>
										<option value="1">01</option>
										<option value="2">02</option>
										<option value="3">03</option>
										<option value="4">04</option>
										<option value="5">05</option>
										<option value="6">06</option>
										<option value="7">07</option>
										<option value="8">08</option>
										<option value="9">09</option>
										<option value="10">10</option>
										<option value="11">11</option>
										<option value="12">12</option>
                                    </select>
                                    <div class="clear">
                                    </div>
                                </td>
                                <td align="left" valign="middle">
                                    <div class="td_spacer">
                                    </div>
                                </td>
                            </tr>
                        </table>
			<div class="clear">
            		</div>
			<div class="header_form left" style="width: 300px">
                            <input type="submit">
                        </div>
                    </form>
                    <!-- end form -->
                </div>
                <div class="ie6_login_spacer">
                </div>
                <div class="spacer20 clear">
                </div>
                <div class="login_content" style="border-top: 1px solid #ddd; padding-top: 5px">
                    <div class="right" style="width: 190px">
                        <div class="spacer">
                        </div>
                    </div>
                    <div class="spacer20 clear">
                    </div>
                </div>
            </div>
            <div class="clear">
            </div>
            <div class="footer_shadow">
            </div>
            <div class="clear">
            </div>
            <div style="color: #84a4be;" class="left">
                <div style="width: 150px" class="left">
                    &copy; Steakhouse Communications
                </div>
                <div class="left">
                    <a href="./login">Sign In</a>
                    |<a href="">Register</a>
                    |<a href="">Legal</a>
                    |<a href="">Links</a>
                </div>
            </div>
            <div class="clear">
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            <div class="spacer20">
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